CYPDICAR 6.25mg Remedica Treatment of hypertension (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Carvedilol
Ingredient Heart failure, high blood pressure, angina

Ingredient

Composition information	Content
Carvedilol	6.25mg

Uses

Indications

CYPDICAR 6.25 drugs are indicated in the following cases:

Treatment of high blood pressure.

heart failure.

angina.

Carvedilol has two main mechanisms of anti -hypertension. A mechanism of action is vasodilation, mainly due to Alpha receptor selection. Therefore reducing peripheral blood vessels. Carvedilol also has a non -selective congestion effect. Vascular dilatation and receptor blockers occur in the same dosage level. Also see the effect of channel blockers - light calcium. Carvedilol does not have the effect of dominance - beta, but only has weak effects stabilizing the membrane. Clinical research has shown that the combination of Alpha L and Beta receptor blockers make the heart frequency slightly decreasing or unchanged when resting, maintaining the amount of auxiliary volume and blood flow in the kidney and peripheral.

pharmacokinetic

absorption

Biology of Carvedilol on average 20-25% because of incomplete absorption and initial strong metabolism.

After taking a dose of about 1-3 hours, the plasma concentration is maximum. The concentration in plasma increases linearly to the dose, within the recommended dose range.

Distribution

The distribution volume is about 2l/kg. Normal plasma clearance is about 590ml/min.

Metabolism and elimination

Three metabolites have the active active receptor of beta, but the vasodilation effect is weak. However, the concentration of these metabolites is low, and therefore does not contribute to the effect of the drug. The half -life of Carvedilol is 6 - 7 hours after drinking. A small percentage of about 15% of oral dose is excreted through the kidney.

Before taking CYPDICAR 6.25mg Remedica Treatment of hypertension (3 blisters x 10 tablets)

How to use

Oral drugs.

Dosage

Hypertension

The first dose of 12.5mg, taken 1 time, increased to 25mg after 2 days, drink once a day.

Other ways, the first dose of 6.25mg oral twice a day, after 1 to 2 weeks increased to 12.5mg, taken 2 times a day.

If needed, the dose may increase, at least 2 weeks apart, up to 50mg, drink 1 time, or divide into several doses.

For the elderly, 12.5mg oral 1 time can be effective.

Angina

The first dose 12.5mg, taken 2 times a day. After 2 days of increasing to 25mg, 2 times a day.

heart failure

The first dose of 3,125mg taken 2 times a day for 2 weeks. After that, the dose may increase, if tolerated, up to 6.25mg, taken 2 times a day.

The dose can increase if tolerant, at least 2 weeks apart, the maximum dose is recommended 25mg, taken 2 times a day, for patients weighing less than 85kg or 50mg, taken 2 times a day, for people weighing over 85kg.

left ventricular ventricles after myocardial infarction

The first dose of 6.25mg oral twice a day, increase the dose after 3 to 10 days, if tolerated, up to 12.5mg oral twice a day and then increase to the target dose of 25mg oral twice a day. The lower starting dose may be used for symptoms.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? The most common symptom of heart is hypotension and slow heart rate. Atrial block - ventricular, ventricular disorders in ventricular and heart stunning may occur at serious overdose, especially with membrane inhibitors (for example: propranolol). The impact on the central nervous system includes convulsions, coma and common respiratory arrest with propranolol and with other fat -soluble drugs and other membrane inhibitors.

Handling

Therapy includes treatment of seizures, hypoglycemia, hyperkalemia and hypoglycemia. Slow heart rate and reducing blood pressure with atropine, isoproterenol, or with a pacemaker that can use glucagon. QRS is expanded due to membrane inhibitor canxicity that can use hypertonic sodium bicarbonate. For multi -dose activated carbon, hemorrhage can only help eliminate the blocks - beta with small distribution, with half a long life, or low internal clearance (acebutolol, atenolol, nadolol, sotalol).

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using CYPDICAR 6.25, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Systemic: headache, muscle aches, one fatigue, shortness of breath.

Digestive: nausea.

circulatory: dizziness, posture hypotension.

Uncommon, 1/100> ADR> 1/1000

Digestive: diarrhea, abdominal pain.

Circulation: Slow heart rate.

Rare, ADR

Blood: platelets, leukopenia.

Digestive: vomiting, constipation.

Eyes: Reduce tears, irritation.

Circulating: poor air -conditioning, fainting.

Central nerve: depression, sleep disorders, paresthesia.

Skin: urticaria, itching, psoriasis.

Liver: Increased liver transaminase.

Respiratory: stuffy nose.

Instructions on how to handle ADR

can minimize the risk of slow heart rate and other undesirable effects by starting treatment at low doses, then gradually increasing the dose, careful monitoring of diastolic blood pressure and heart frequency, and taking carvedilol with food.

Need to reduce the dose if the circuit frequency drops below 55 cycles per minute. Avoid stopping the drug suddenly.

Patients must avoid standing up suddenly or standing still for a long time, need to rest if they feel dizzy or go and consult the physician about the dose reduction.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

CYPDICAR 6.25 Contraindications in the following cases:

Sensitive to any ingredients of the drug.

Sound congestive heart failure (NYHA level 111 - IV).

Symptomatic liver disease, impaired liver function.

Cardiac shock, heavy heartbeat or atria - ventricular II or III.

Bronchial asthma or bronchospasm (can lead to asthma attack).

Be cautious when used

Carvedilol caution in patients with congestion heart failure treated with digitalis, diuretics, or enzyme inhibitors Angiotensin transferred because the atrial - ventricular can be slowed down. Caution must be used in patients with diabetes with no or difficult to control, because beta receptor blockers can cover symptoms of blood glucose.

Must be cautious in people with border blood vessels, anesthetic patients, people with hyperthyroidism.

If the patient does not tolerate other anti -hypertension drugs, caution can be used with very small doses of carvedilol for people with bronchospasm.

Must stop treatment when there is signs of liver damage.

Consider the risk of arrhythmia, if using Carvedilol simultaneously with the anesthetic group.

Must consider the risk if combining Carvedilol with anti -arrhythmia group 1.

Avoid stopping the drug suddenly, to stop the drug for 1-2 weeks.

The ability to drive and operate machinery

so far no side effects have affected the ability to drive and operate machinery.

Pregnancy

Carvedilol has caused clinical harmful effects on pregnancy. Only use this medication during pregnancy if the expected benefit is greater than the risk that may occur and as usual, not used in the last three months of pregnancy or almost giving birth.

Unwanted effects for fetuses such as slow heartbeat, reducing blood pressure, and respiratory inhibitors. Reducing blood glucose and reducing body temperature in newborns can be used by pregnancy.

Breastfeeding period

Carvedilol can excrete in breast milk without the risk of unwanted effect in breastfed babies.

Drug interaction

Reducing effects

Rifampicin can reduce plasma concentrations of carvedilol to 70%.

The effect of other beta blockers decreases when combined with aluminum salts, barbiturates, calcium salts, cholestyramin, colestipol, non -selective blockers of Alpha, penicillin (ampicilin), salicylate, and sulfinyrazon due to biodiversity and plasma concentration.

Increase effect

Carvedilol can increase the effects of anti -diabetes drugs, channel blockers - calcium, digoxin.

Carvedilol's interaction with clonidin can lead to an increase in blood pressure and reduce heart rate.

cimetidine increases the effects and bioavailability of carvedilol.

Other drugs that are capable of increasing the concentration and effects of carvedilol include quinidin, fluoxetin, paroxetin, and propafenon because these drugs inhibit CYP2D6.

Carvcdilol increases the concentration of digoxin about 20% when taken at the same time.

Storage

Should be stored in dry, cool places, temperatures from less than 30 degrees Celsius and for children's reach.

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